Certified nurse midwife

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See also: Types of health care providers

SCOPE OF PRACTICE

The nurse-midwife is educated and trained to provide a broad range of health care services for women and newborns. CNM functions include diagnosis (taking a medical hystory, doing a physical assessment, ordering laboratory tests and procedures), managing therapy (outlining care, providing prescriptions, coordinating consultations and referrals), and activities that promote women's health and reduce health risks.

Although most of the CNM practice focuses on childbearing, family planning, and gynecological care for well women, CNMs may also check and manage common illnesses in adults. All services are done together with the patient.

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As with the nurse practitioner profession (NP), CNMs are legally allowed to write prescriptions in some states but not in others. CNMs provide independent health care management, consultation or co-management, and referral services.

PRACTICE SETTINGS

Certified nurse-midwives work in a variety of settings, including private practices (either by themselves or together with a physician), health maintenance organizations (HMOs), hospitals, health departments, and birthing centers. CNMs often provide care to underserved populations in rural areas or inner-city settings.

REGULATION OF THE PROFESSION

As with many other professions, certified nurse-midwives are regulated at 2 different levels. Licensing occurs at the state level and falls under specific state laws. As with other advanced practice nurses (such as nurse practitioners), license requirements for CNMs can vary from state to state. The current trend is to require a master's degree and national certification.

Certification is done through a national organization and all states have the same requirements for professional practice standards. Only graduates of nurse-midwifery programs accredited by the American College of Nurse-Midwives (ACNM) are eligible to take the certification exam given by the ACNM Certification Council, Inc.

Review Date: 09/02/2009
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).